Revenue Cycle Management

We have gained valuable expertise from partnering with leading hospitalist groups and can offer consulting to help you improve in areas of

  • Billing and Coding Research
  • Comparative Rate Modeling
  • Pricing
  • Performance Analysis
  • Cost Analysis
  • Regulatory Compliance
  • Accounts Receivable Services
  • Medical Billing
  • Practice Management
  • Patient Care Management
  • Patient Communications
ICD-10 Transition

Centers for Medicaid and Medicare Services (CMS) has delayed the deadline for compliance with the diagnostic code set from October 1, 2013 to October 1,2014. This has given practices some time to transition all diagnosis codes from the ICD-9 system to more than 65,000 codes included in the ICD-10 version. This change will impact every system, process and operation that uses a diagnosis code. Most Healthcare facilities are still not prepared for this change. Without a proper plan in place, they are at high risk of losing time and money as the dead line approaches.

This is where Hospitalist-IQ can help as we offer the features such as:

  • With the transition of ICD-10 automatic code search, it will make it very easy for care providers and coders less challenging when entering new diagnosis and code sets
  • Ready available new set of codes within Hospitalist-IQ
  • Allow users to navigate through by selecting the most appropriate and accurate ICD-10 code

Steps to facilitate the Transition to ICD-10

There is a lot of activity on implementation of ICD-10 for hospitals but the body of knowledge for physician practices and medical groups is sorely lacking. ICD-10 – the World Health Organization’s 10th revision of the International Statistical Classification of Diseases and Related Health Problems- is a huge undertaking for any medical practice. Under this revision, only diagnosis code – not procedure codes- change for practices and groups.
Although Physician payment is not driven by diagnosis code, physicians are still required to show medical necessity, which is where practices MUST be thoroughly prepared to bridge the gap to this new code set.

Here are the steps to ease transition:

  1. Collaborate: collaborate with hospitals who are already compliant as will have a team that has been working for months on understanding and perfecting the transition to ICD-10
  2. Identify Key Stakeholders: choose few key stakeholders in your practice to decide which changes will have the most impact. Each leader can choose one or two diagnosis to study and then educate the rest of the group regarding the ICD-10 impact on diagnosis, treatment, documentation, billing and revenue. Groups are encouraged to meet on a regular basis and create a thorough training manual for the entire organization
  3. Take Small Steps: Think of the extended deadline as an advantage that allows you to train employees in small increments. This way the entire transition is not so overwhelming.
  4. Whole Practice Approach: look at ICD-10 as opportunity for everyone to learn about each facet of the healthcare services your practice provides. Note that family practices, hospitals and internal medicine groups may have a more difficult time converting from ICD-9 to ICD-10 than specialists. This is because generalists see a large variety of patient conditions, their documentation and support staff must be educated in all anatomy, physiology and disease processes. Specialists, on the other hand, treat a limited subset of patient population, so their documentation needs to be refined in only a few key areas.
  5. Analyze: analyze current preparedness. Are you already well on your way to compliance? Take some time to review each staff member’s knowledge of coding procedures. By analyzing our situation early, it will give you ample time to take methodical step-by-step approach to transitioning to ICD-10.
  6. Testing: A period of parallel testing with both ICD-10 and ICD-9 codes is highly recommended. This process of dual coding of cased will identify gaps in clinical documentation where medical necessity under ICD-10 may fail and cases will be denied. Dual coding supports end-to-end testing with clearinghouses and payors — even if technologies are not quite ready for ICD-10.
  7. Contribute: ICD-10 offers an opportunity to work with like practices, payors and hospitals as a regional consortium on common issues. Reach out to your regional community and create an ICD-10 forum. Be forthcoming about how you are handling specific ICD-10 issues and listen to other members ideas and support.